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HomeMy WebLinkAbout05-22-07PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Estate of Barbara Lee Freysinger ~-7~~ ~~.~~ File Number ~ ~ 'd'~~ J c.L~ - - ~7 also known as - - - Deceased Social Security Number 174-20-6761` r-~ - -- Millazd C Frevsinger - ~" Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE 'A' or 'B' BELOW.) --- t. w~ ® A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is 1-aze-the Executor ~ nar~etl in the last Will of the Decedent dated July 2, 2004 at~d-oedieii(sj~sted- (State relevant circumstances, e.g., renunciation, death of executor, etc.) Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the instrument(s) offered for probate, was not the victim of a killing and was never adjudicated an incapacitated person: B. Grant of Letters of Administration (If applicable, enter: c.t.a.; d.b.n.c.t.a.; pendente life; durance absentia; durance mtnoritate) Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs: (If Administration, c. t. a. or d.b.n.c.t.a., enter date of Wil! in Section A above and complete list of heirs.) (COMPLETE INALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in Cumberland County, Pennsylvania with tristher last principal residence at 530 16th Street New Cumberland Penns lvania 17070 (List street address, town/city, township, county, state, zip code) Decedent, then 80 years of age, died on December 30, 2006 at 530 16th Street, New Cumberland, Pennsylvania Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property $ 110,000.00 (If not domiciled in PA) Personal property in Pennsylvania $ (If not domiciled in PA) Personal property in County $ 0.00 Value of real estate in Pennsylvania $ 110,000.00 situated as Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of Letters in the appropriate form to the undersigned: I~,Q~c Millazd C. Freysinger /~ ~ 530 16th Street, New Cumberland, PA 17070 Form RW-02 rev. 10.13.06 Page I Of 2 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA SS COUNTY OF Cumberland The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are true and correct to the best of the knowledge and belief of Petitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed and ubscribed nn ^^ Signature of Personal Representative before me the O~ daynof Signature of Personal Representative `~ ~ (7 ;:. -_7 For the Register Signature of Personal Representative - `~-- _. ; ; File Number: ~~ " d1 -~]~~ ~ ' Estate of Barbara Lee Freysinger ,Deceased r.,~ Social Security Number: 174-20-6761 Date of Death: December 30, 2006 AND NOW, in consideration of the foregoing Petition, satisfactory proof having been presented befor e, IT IS DECREED that Letters Testamentary are hereby granted to Millard C. Freysinger in the above estate and that the instrument(s) dated July 2, 2004 described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent. FEES Letters ............... ~(l QU •l1U Short Certificate(s) .. (5)... $ 0~0 • cx~ Renunciation(s) .......... $ 1,~~ tl ... $ 15 -cx~ 1e P ... $ Io • ~~ s~2 ~irr~ ... $ S ~ OCR ... $ ... $ ... $ ... $ ... $ ... $ TOTAL .............. ~~%C7 C~ Attorney Signature: Supreme Court I.D. No.: 7217 Address: Telephone: 3401 North Front Street PO Box 5950 Harrisburg, PA 17110-0950 717-232-5000 Form RW-02 rev. ~o.~s.o6 ~ Page 2 of 2 Attorney Name: Howell C. Mette 105.805 REV 1/OS This is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $6.00 Local Registrar P 13104410 No. 3 Rev. 2187 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS CERTIFICATE OF DEATH NAME OF DECEDENT (First, Middle. Lalel SE% SOCIAL SECURITY NUMBER V _~ DATE OF DEATH (Month, Day, Peer) ~• Lee 1 V ~' ! ~ ' ~r° 2• -eu.al 3.174 - 20 - 6761 4•December 30 2006 AGE (Leal BiMdey) UN R i YEAR UN R 1 DAY DQE OF &RTH (Morph Da Vnr) BIRTHPLACE (Gpy end St l F i C PLACE OF DEQH (Check ody one - sea inatruclioru on Doter side) Momha r Days Hours r MlnNee . y, a e « gn «e aunhy) HOSPRAL: OTHER: $0 Yn• ~ 12/26/26 ~larrisburg PA ~'""'^ ERrowpatlent^ DoA^ y ~ ^ Reaidenca`CJ sp'„ ^ 6, 6. , ( y) COUNTY OF DEATH Crt1', BORO. TWP OF DE1QH FACILITY NAME (If nd irwtituaon, give street and number) WA S D E CEDENT OF HISPANIC ORIGIN? RACE -American Mdlen, &ack Whhe etc / ~ V1 ~~1, , , . Nd%J Yn ^ If yea, epseity Cuban ~~~) , 530 16th Street Meuican,PuertaRkan,Na, white eb. Cumberland k~Iew Cumberland w . 9. 10. CEDENi'S USl1AL OCCUPQION KIND OF BUSINESSANDUSTRV WAS DECEDENT EVER IN DECEDENT'S EDl1CATION MARIULL STQUS•Marrled SURVIVING SPOUSE (Dive kind d work done doing moat U.S. ARMED FORCEST h aM cam Navar Manled, Wkbwed, pf wpe Siva mefdan name) , of wodkq I6e; M not use retired J ElementarylSec«Wary Co6ege Divorced (Specify) "°'^ "°® ,,., re istered nurse „h• healthcare ~~~ n~4«s+)+4 married Millard C. Fre sin e 12. 13. 11. i6. y g DECEDENT'S MAILING ADDRESS S i /T ' ( beet C ry Own, Slate, Zip Code) OECEDENr S Penns lvania t "SAL na. aura ~' Da ne ^ Yea dscedant llwdln 530 16th St . , _ ree RESIDENCE decetlsm ^~~ New Cumberland, PA 17070 ~°a ~i~ Cumberland '" "e „w„~ her p7 T~ No, decedent lived New Cumberland 16. 17b. Coca 1Td~Y wkMn adwl Iknys of ceylbom. FATHER'S NAME , Midde, Last) ~ MOTH S NAMF, (Prat Middle, Maiden Surname) Linwoo~ Burton Anderson ~enrietta 1e Stonesifer 1S. IN FOLtytl~yr~arE(rypelPnrn) C. Freysinger O l f 1 ~py ~a FORMA[J'(~IAILIVtlI ~~r,"`i`lew°'l;umDe~and, PA 17070 ~ ~ j ~ f l ~ ~ ~ METH OD O F DISPO S Tfldp(N, DATE OF DI9POSTTION PLACE OF D I S P O S NION-NamedCemetery, Crematory LOCATION-City/Town, State, Zp Code 8udal U Cremetbn ^ Removal hom Stele ^ O«,.tlen^ other(speciyl ^ 2b. (Marto'. Day 19ar) O1/06/07 21b. «gher Place ~tolli~ng, Green Memorial Park te. ~.ower Allen 1tap. , PA 21 . SKtNQURE ERAL VI ICENSEEORPERSONACTINGAS8UCH LICENSE NUMBER NQd D/~f~F~S3 CILI ar a~rtOT q ~~ +~3~, few umbergan A /s~0 m 2zb _ 220 Complete gems ony wMn certNylrp To the best of my knovdedge, death occurred at the time, date and place stated. LICENSE NUMBER DQE SIGNED physician b rat avellede of time d daaM to (Signahue end Title) (Modh Dey Year) cenlly cause of death. , , ' , ~• hams 2426 moat De completed tfy TIME OF DEATH , ~) 1 ' DQE PRONOU ~ D DEAD (MOntll, Day, Year) WAS CASE REFERRED TO MEDICAL F~fAMINERM.ORONER7 parson who pronouraes death. Y ^ ['~ ~ ^.~~ • C,~ ~ ea No 24 ` V v M 25 26 . . . . 27. PART L Enter its tlleeasea, injurba or complMatrorro which caused iha deem. Do rat emer the mode of dyirq, such as cardiac or respiratory arrest shock or heart failure. f Approxhnate PART II: Other signifaant cond'niona wnmbuting ro death but , LM onty one cause on eats tine. ~ Interval between not reauMng in tM underlying ceuee gWen In PART I. IMMEDIATE CAUSE (Final t onset end tlaelh diamee «condabn '. 1 v ~~ j ~~~ r raeuhirp in death)-- e. DU TO (OR AS CONSEQUENCE OF): ~ _ Sagndlaey lot condhbns b. Harty, leadktgroimmwate DVE lO (OR ASACONSEQUENCE OF): ( atres.Eder UNDF.RLY61O l CAWE(Diseeae«inpuy c f Mat irpseted events DUE TO (OR AS A CONSEOUENCE OF7: reauping in deem/ LAST I d. t WMS AN AUTOPSY WERE AUTOPSY FlNDINGS MANNER OF DEQH DQE OFIWURV TIME OFINJURV INJURVQ WORK? DESCRIBE HOWINJURY OCCURRED. PERFORMED? AIMILABLE PRIOR TO (Month, OaY. Veer) COMPLETION OF CAUSE ~( NMUraI LJ H kitl F [ EQH ^ om e O ) 7 ~ ^ ~ ^ AccWent ^ Pendeq Investigation ^ omce M 90r: LOCQION Yen ^ No ^ Yea ^ No ^ Stddde ^ Could rat be determined ^ PLACE OF INJURY - At home l ~ureN Iedo S R , , ry, ( treet Ciry own, State) buyding, etc. (Specify) M. 2fib. 26. 90e. 301, CERTIFIF.A (Check ony one) •CERTIFYRiD PHYSICIAN (Physician ceripying cause d death when arodw physician has pronounced death and comdetetl Item 23) T or h f kr wletl sh l M W d b B d d SIGNQURE LE OF CERTIFIER o e ea o my a ge, a ooeurt w IS ausa(s) an manneraa steb ..................................................... 31b. 'PIIONOUNCING AND CERTIFYING PNVSIdAN (Physician hdh prorauroing deem arW cerHlying to cause d deem) LICENSE N MBER ,~ _ ~ DQE SIGNED (Monts, Dey, year) . To Ore heat o/ my knoerledps, death aewmtl at tM tkne, dale, and pleee, aM dw b fM cane(s) and menrter ae sblad .......................... ^ 310. ' ' 3rd. ." ~ ~'(/ 'MEDICAL EXAMINERlCORONER NAME AND ADDRESS OF PERSON WHO COMPLETED CAUSE OF DEQH (Item 27) Type or Pdnt _ .. ~ ~' ~ ~ I~ ~ On the bob of sxsminMlon and/or Imsatlpation, b my opinion, death oeeurcad ai tM time, dab, and pbea, end due to the cause(s) ertd mennerr sbted ^ ~ (/ { ~ e ~~o ~ . . Lt' ~1. ~ I ............................................................................................... 31a. 32. ~. REGISTRAR'S SIGNQURE AN~ER ~ / ~ / DQE FILED (Month, Gay, weer) ~ ' 34. ~ ~ D 7 JAN 0 3 2007 ~~.~~ V'V' Illlll ~.7CIlQ1L ~~~~~IIIl'b~7C11~ OF BARBARA L. FREYSINGER I, BARBARA L. FREYSINGER, of Cumberland County, Pennsylvania, do make, publish and declare this to be my Last Will and Testament, hereby revoking all Wills and Codicils by me at any time made. _ _ ITEM I: I direct that all inheritance and estate taxes becoming due by reason of my death, whether payable by my estate or by any. - recipient of any property, shall be paid by the Executor out of the residue of any . . estate, as an expense and cost of administration of my estate. The Executor shall have no duty or obligation to obtain reimbursement for any such tax so paid, even though on proceeds of insurance or other property not passing under this Will. ITEM II: I direct the Executor to pay the expenses of my last illness and funeral expenses from the residue of my estate as an expense and cost of administration of my estate. ITEM III: If I die before my husband, MILLARD C. FREYSINGER, I give to him all of my household furniture and furnishings, books, pictures, jewelry, silverware, automobiles, wearing apparel and all other articles of household or personal use or adornment and all policies of insurance thereon. If I do not "die before my husband, I make this gift to my children living at the time of my death, to be divided among them as they shall agree. Should there be no agreement, the Executor shall divide this property among them in as nearly equal portions as the Executor, in the sole discretion of the Executor, deems appropriate, having due regard to the personal preferences of my children. Page 1 ~`~~, , ITEM IV: I give the residue of my estate, not disposed of in the preceding portions of this Will, to my husband, MILLARD C. FREYSINGER, as Trustee, IN TRUST, to be divided into two parts, each of which shall constitute separate trust funds to be known as "Trust A" and "Trust B." "Trust A" : "Trust A" shall consist of a fraction of my residuary estate. The numerator shall be a sum equal to the largest amount that can pass free of Federal estate tax under my Will by reason of the applicable credit amount and the state death tax credit (provided that the use of this credit does not require an increase in state death taxes) allowable to my estate but no other credit and after taking account of dispositions under other items of this Will and property passing outside of this Will which do not qualify for the marital or charitable deduction and after taking account of charges to principal that are not allowed as deductions in computing my Federal estate tax. The denominator shall be the value of my residuary estate. For purposes of establishing this fraction, the values finally fixed in the Federal estate tax proceeding relating to my estate shall be used. I recognize that the numerator of this fraction may be zero (0), in which case no property shall pass to "Trust A." I also recognize that the numerator maybe affected by the action of the Executor in exercising certain tax elections. "Trust B": "Trust B" shall consist of the balance of my residuary estate not placed in "Trust A." ITEM V: The following provisions shall apply to "Trust A": ,~t~ , Page 2 (a) The Trustee shall pay the net income arising from the principal of this Trust in convenient, at least annual, installments to my husband, MILLARD C. FREYSINGER, during his lifetime. (a) During the lifetime of my husband, the Trustee shall pay to or for the benefit of my husband so much of the principal of this Trust as may be necessary, in the sole discretion of the Trustee, for the proper support, maintenance and medical care of my husband. (c) Upon the death of my husband, the Trustee shall divide the principal and any accretions thereto and any accumulations of income into as many equal parts as there are the then following listed children of mine who are then living or if then deceased, are represented by then living issue. The Trustee shall distribute one such share to each of such then living children, and shall hold one such share as a separate Trust for the benefit of the issue of each such then deceased child, per stirpes: PATRICIA L. FREYSINGER LAURA L. FREYSINGER DAVID S. FREYSINGER ALAN J. FREYSINGER VALERIA J. FREYSINGER MARY C. FREYSINGER (d) In each Trust established for the benefit of the issue of a deceased child of mine, the Trustee shall quarterly pay the net income to or for the benefit of the issue of my deceased child, per stirpes, living at each time of quarterly distribution. As soon as any issue of my deceased child attains the age of twenty-one (21) years, and in no event Page 3 later than twenty (20) years following the death of the survivor of my husband and me, the Trustee shall distribute the remaining principal to the then living issue of my deceased child, per stirpes. (e) If at any time before final distribution of the assets of any of the Trusts established for issue of deceased children, there are no living beneficiaries of said Trust, the Trust shall terminate, and its assets shall be distributed to my other children if then living, or if a child is not then living to such child's then living issue, per stirpes. The share payable to the issue of deceased children hereunder shall continue to be held in trust for the benefit of said issue in accordance with the provisions of subparagraph (d), provided, that if any of the Trusts herein created for the benefit of issue of deceased children have been terminated by the payment of its principal to its beneficiaries, the beneficiaries who received payment of the principal of that Trust shall collectively be considered an "existent Trust" for the purposes of this paragraph, and one equal share shall be paid directly to such beneficiaries in the same proportion by which they received the principal of the Trust, or, if any such beneficiary is deceased, to the issue of such beneficiary, per stirpes. ITEM VI: The following provisions shall apply to "Trust B": (a) Trustee shall, beginning at my death, pay over the net income in convenient, at least annual, installments to my husband, MILLARD C. FREYSINGER, during his lifetime. (b) The Trustee shall also, from time to time, pay to my husband so much of the principal of this Trust as the Trustee deems Page 4 necessary for the proper support, maintenance and medical care of my husband. (c) Upon the death of my husband, the Trustee shall pay all accrued income and all income accumulated but undistributed to the estate of my deceased husband. The Trustee shall thereafter transfer the principal of this Trust to "Trust A" to be held, administered and distributed in accordance with the provisions of ITEM V of this Will. (d) If my husband should not survive me, the provisions of "Trust B" shall be void. The part of my estate which would have constituted "Trust B" shall be added to "Trust A" to be disposed of in accordance with ITEM V of this Will. (e) The Executor is authorized in the Executor's exclusive and unrestricted discretion to determine whether to elect (under Section 2056(b)(7) of the Internal Revenue Code of 1986 as amended, or any corresponding provision of the Federal estate law), to qualify all, none or a fraction of "Trust B" for the Federal estate tax marital deduction. The Executor's decision with respect to this election shall be binding upon all persons. Only property which is fully eligible for the marital deduction under Federal estate tax law shall be assigned to this Trust. Notwithstanding anything to the contrary contained in this Will, the Trustee shall not retain or invest in any property which is or becomes unproductive. Notwithstanding the provisions of subparagraph (c) of this Item, the Trustee shall promptly pay to the Executor of my husband's estate, out of the principal of this Trust upon the death of my husband, an amount equal to the estate, inheritance, transfer, succession and other death taxes ("death taxes"), Federal, state and other, payable by reason of the inclusion of the value of Trust property Page 5 ~ ~`` in my husband's estate. This payment shall equal the amount by which (1) the total of the death taxes paid by my husband's estate exceeds (2) the total of the death taxes which would have been payable if the value of the Trust property had not been included in his estate. My husband's Executor shall determine the amount payable, and the determination shall be final. The determination of the amount due shall be based upon values as finally determined for Federal estate tax purposes in my husband's estate. After payment of the amount determined to be due hereunder, the Trustee shall be discharged from any further liability with respect to payment. My husband may waive his estate's right to payment under this subparagraph by Will, executed after my death, in which he specifically refers to this right. ITEM VII: No part of the income or principal of any Trust created by this Will shall be subject to attachment, levy or seizure by any creditor, spouse, assignee or trustee or receiver in bankruptcy of any beneficiary prior to his or her actual receipt of income or principal distributed. The Trustee shall pay the net income and the principal to the beneficiaries specified by me, as their interests may appear, without regard to any attempted anticipation, pledging or assignment, and without regard to any claim or attempted levy, attachment, seizure or other process against the beneficiary. ITEM VIII: The Executor and the Trustee shall each possess the following powers, each of which may be exercised without court approval and in a fiduciary capacity only: (a) To retain any investments I have at my death, including specifically those consisting of stock of any bank even if I have named that bank as the Executor or Trustee. Page 6 -,~'~' T (b) To vary investments, and to invest in bonds, stocks, notes, real estate mortgages or other securities or in other property, real or personal, without being restricted to so-called "legal investments," and without being limited by any statute or rule of law regarding investments by fiduciaries. (c) In order to divide the principal of a Trust or for any other purpose, including final distributions, the Executor and Trustee are authorized to divide and distribute personal property and real property, partly or wholly in kind, and to allocate specific assets among beneficiaries and Trusts so long as the total market value of each share is not affected by the division, distribution or allocation in kind. The Executor and Trustee are each authorized to make, join in and consummate partitions of lands, voluntarily or involuntarily, including giving of mutual deeds, or other obligations, with as wide powers as an individual owner in fee simple. (d) To sell either at public or private sale real and personal property severally or in conjunction with other persons, and to consummate sale(s) by deed(s) or other instrument(s) to the purchaser(s), conveying a fee simple title. No purchaser shall be obligated to see to the application of the purchase money or to make inquiry into the validity of any sale(s). The Executor and Trustee are authorized to execute, acknowledge and deliver deeds, assignments, options or other writings as necessary or convenient to any of the power conferred upon the Executor and Trustee. (e) To mortgage real estate, and to make leases of real estate. Page 7 ~- ~ (f) To borrow money from any person, including the Executor or Trustee, to pay indebtedness of mine or of my estate, expenses of administration or inheritance, legacy, estate and other taxes, and to assign and pledge assets of my estate or any Trust established by this Will. This paragraph shall not be construed to authorize borrowing from "Trust B." (g) To pay all costs, taxes, expenses and charges in connection with the administration of my estate or any Trust established under this Will. If any death taxes are payable with respect to my estate, these taxes shall be paid from "Trust A. (h) To make distributions of income and of principal to the proper beneficiaries, during the administration of my estate, with or without court order, in such manner and in such amounts as the Executor deems prudent and appropriate. (i) To vote shares of stock which form a part of my estate or any Trust established under this Will, and to exercise all the powers incident to the ownership of stock. (j) To unite with other owners of property similar to property in my estate to carry out plans for the reorganization of any company whose securities form a part of my estate. (k) To disclaim any interest in property which would devolve to me or my estate by whatever means, including but not limited to the following means: as beneficiary under a will, as an appointee under the exercise of a power of appointment, as a person entitled to take by intestacy, as a donee of an inter vivos transfer, and as a donee under a third-party beneficiary contract. ~r, ~, Page 8 ~s `=~~ (1) To prepare, execute and file tax returns of any type required by applicable law, and to make all tax elections authorized by law. (m) To employ custodians of property, investment or business advisors, accountants and attorneys as the Executor or Trustee deems appropriate, and to compensate these persons from assets of my estate or trust, without affecting the compensation to which the Executor and Trustee are entitled. (n) To divide any Trust created in this Will into two or more separate Trusts so that inclusion ratio for purposes of the generation-skipping transfer tax shall be either zero or one, in order that an election under Section 2652(a)(3) of the Internal Revenue Code may be made with respect to one of the separate Trusts, or for any other reason. (o) To allocate administrative expenses to income or to principal, as the Executor or Trustee deems appropriate. However, no allocation to income shall be made if the effect of the allocation is to cause a reduction in the amount of any estate tax marital deduction or estate tax charitable deduction. (p) To do all other acts in their judgment necessary or desirable for the proper and advantageous management, investment and distribution of the estate and Trusts established under this Will. ITEM IX: The Trustee is authorized to distribute principal and/or income in any one or more of the following ways if the Trustee, in the sole discretion of the Trustee, considers the beneficiary unable to apply Page 9 ~ ~' ~ distributions to the beneficiary's own best interests, or if the beneficiary is under a legal disability: (a) Directly to the beneficiary; (b) To the Trustee, or to another person selected by the Trustee, as custodian under the Pennsylvania Uniform Transfers to Minors Act as to a beneficiary under the age of twenty-one (21) years; (c) To a relative of the beneficiary, to be expended by that relative for the benefit of the beneficiary; or (d) By directly applying distributions for the benefit of the beneficiary. This power shall not apply to any distribution to my spouse from any trust which has qualified for the marital deduction in my estate. ITEM X: Any person who has died within thirty (30) days of my death shall be deemed to have predeceased me. ITEM XI: I appoint my husband, MILLARD C. FREYSINGER, to be the Executor. In the event of his death, inability or refusal to serve as Executor or Trustee, I appoint my daughters, PATRICIA L. FREYSINGER and VALERIA J. FREYSINGER, to be the Executors and Trustees. The Executor and Trustee are specifically relieved from the duty of filing bond or entering security. Page 10 IN WITNESS WHEREOF, I have set my hand and seal to this, my Last Will and Testament, consisting of this and the preceding ten (10) pages, at the end of each page of which I hav~also set my ini ials f r greater security and better da of ~ , 2004. identification this ~ y (SEAL) BARBA L.FREY We, the undersigned, hereby certify that the foregoing Will was signed, sealed, published and declared by the above-named Testatrix as and for her Last Will and Testament, in the presence of us, who, at her request and in her presence and in the presence of each other, have hereunto set our hands and seals the day and year first above written, and we certify that at the time of the execution thereof, the said Testatrix was of soun and disposing mind and memory. ~~ ' ~ EAL) Residing at 2 ~ ~ ~ ' ~~ / ~ dt. ~ ~-~ ~`~ a~ ~ ~ ;~ ~ r "',~ (SEAL) Residing at 13 3 8 ~ah~ v~ ~ ~ ~ ~' C,r ;~,~,~~~ . ~~~~ ~~~-Zag -~~ S ) Residing at 403067v1 --~ ,. -(_) -~ )7 OATH OF SUBSCRIBING WITNESS(ES) ', G TER OF WILLS COUNTY, PENNSYLVANIA -' a e ~.,., E ~~-- ~~~ ~~~ \ ~ t t ,Deceased Estate of ~~,~~~ C ~M~.T-T-~ ~ ~~ 1i~(~~p ('~ ~~1,~~ ach) a subscribing witness to ~1~ (Print Names) the L'~~Will C-~ ac,~ )presented herewith, (each) being duly qualified according to law, deposes}-and say(s~that she /~ /they was /were present and saw the above ~/ Testatrix sign the same and that she /~ffie~}' signed the same and that - - 6 signed as a witness at the request of the ~estatzn' /Testatrix in her /his presence and in the presence of each other. 14~~..~GCP B 4~- (Signature) Zc~ 5 1•~ - 210`` ~ ~ - (Street Address) ~~ ~ ~, pG ~ ~~~ l (City, State, Zip) ~~ (Signature) ~3o ccJ ~~~` S~' (Street Address) ~!~ ~~ u16 ew (a ~~ ,~~ X70 7~ (City, state, zip) Executed in Register's Office Sworn to or affirmed anc} subscribed before me this ~ ~1 day of ~ ~~-• l~.~ D uty or Reg> ter of Wills Executed out of Register's Office Sworn to or affirmed and subscribed before me this day of Notary Public My Commission Expires: (Signature and Seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's Commission.) NOTE: To be taken by Officer authorized to administer oaths. Please have present the original or copy of instrument(s) at time of notarization. Form RW-03 rev. !0.13.06